Pharmacological Management of Chronic Gastroparesis

The aim of this article is to provide the practicing gastroenterologist and trainee as well as internists and primary care physicians a broad based review of pharmacological therapy available for the medical management of patients with chronic gastroparesis. We emphasize aggressive combination treatments involving antiemetics, prokinetics, and analgesics and discuss guidelines for clinicians to achieve symptomatic control of this very challenging clinical entity. Advances in understanding the mechanisms associated with chronic nausea and vomiting, as well as gastric stasis, have set the stage for therapies which are better targeted to underlying pathophysiology as well as for more rational pharmacologic approaches.